Racial differences in associations between adverse childhood experiences and physical, mental, and behavioral health

Tracy Lam-Hine; Corinne A Riddell; Patrick T Bradshaw; Michael Omi; Amani M Allen

doi:10.1016/j.ssmph.2023.101524

Racial differences in associations between adverse childhood experiences and physical, mental, and behavioral health

SSM Popul Health. 2023 Oct 8:24:101524. doi: 10.1016/j.ssmph.2023.101524. eCollection 2023 Dec.

Authors

Tracy Lam-Hine¹, Corinne A Riddell^{2

3}, Patrick T Bradshaw³, Michael Omi⁴, Amani M Allen^{3

5}

Affiliations

¹ Stanford University School of Medicine, Division of Epidemiology & Population Health, 1701 Page Mill Road, Palo Alto, CA, USA.
² University of California Berkeley School of Public Health, Division of Biostatistics, 2121 Berkeley Way West, Berkeley, CA, USA.
³ University of California Berkeley School of Public Health, Division of Epidemiology, 2121 Berkeley Way West, Berkeley, CA, USA.
⁴ University of California Berkeley Department of Ethnic Studies, 506 Social Science Building, Berkeley, CA, USA.
⁵ University of California Berkeley School of Public Health, Division of Community Health Sciences, 2121 Berkeley Way West, Berkeley, CA, USA.

Abstract

Purpose: Adverse childhood experiences (ACEs) are associated with poor adulthood health. Multiracial people have elevated mean ACEs scores and risk of several outcomes. We aimed to determine whether this group should be targeted for prevention efforts.

Methods: We analyzed three waves (1994-2009) of the National Longitudinal Study of Adolescent to Adult Health (n = 12,372) in 2023, estimating associations between four or more ACEs and physical (metabolic syndrome, hypertension, asthma), mental (anxiety, depression), and behavioral (suicidal ideation, drug use) outcomes. We estimated adjusted risk ratios for each outcome in modified Poisson models interacting race and ACEs. We used the interaction contrast to estimate race-specific excess cases per 1000 relative to Multiracial participants.

Results: Excess case estimates of asthma were smaller for White (-123 cases, 95% CI: -251, -4), Black (-141, 95% CI: -285, -6), and Asian (-169, 95% CI: -334, -7) participants compared to Multiracial participants. Black (-100, 95% CI: -189, -10), Asian (-163, 95% CI: -247, -79) and Indigenous (-144, 95% CI: -252, -42) participants had fewer excess cases of and weaker relative scale association with anxiety compared to Multiracial participants.

Conclusions: Adjusted associations with asthma and anxiety appear stronger for Multiracial people. Existing ACEs prevention strategies should be tailored to support Multiracial youth and families.

Keywords: Adverse childhood experiences; Anxiety; Asthma; Racial groups.